Referral & Authorization Specialist

Aviva Health; Roseburg (OR); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Monday - Friday Scheduling

Paid Holidays

PTO

Comprehensive Medical, Dental, and Vis

403(b) Retirement with Employer Match

Training and professional development

Job summary

Aviva Health is a federally qualified health center in Oregon seeking a Referral Coordinator to manage referrals, authorizations, and related documentation. You will work with providers, patients, and insurers to ensure timely access to services and continuity of care.

Responsibilities include processing referrals, obtaining prior authorizations, and maintaining EMR records, while upholding HIPAA standards and providing compassionate support to patients and families.

Qualifications

• High school diploma or equivalent required.
• Experience in healthcare settings or referral coordination preferred.
• Experience with EMR and healthcare software preferred.
• Knowledge of insurance authorizations and prior authorizations preferred.
• Strong organizational and time-management skills.
• Excellent verbal and written communication.
• Ability to handle confidential information per HIPAA.
• Ability to work independently and as part of a team.

Responsibilities

• Review and process referral orders via the EMR, verifying completeness and insurance requirements.
• Process internal and external referrals in a timely manner with required documentation.
• Monitor outstanding referrals and follow up after 72 hours to prevent delays.
• Obtain and process insurance prior authorizations for referrals and imaging.
• Process medication prior authorization requests and coordinate with pharmacies and insurers.
• Investigate denied or delayed referrals and pursue alternatives.
• Coordinate Veterans Community Care referrals and authorizations.
• Maintain accurate documentation of referral activities in the EMR.
• Communicate with patients about referral statuses and scheduling.
• Coordinate with providers, clinics, and insurance representatives.
• Track referral outcomes and follow-up actions.
• Follow HIPAA and confidentiality policies.

Skills

Organizational skills

Time management

Communication skills

Confidentiality awareness

Education

High school diploma or equivalent

Tools

EMR systems

Job description

Aviva Health is a federally qualified health center in Oregon seeking a Referral Coordinator to manage referrals, authorizations, and related documentation. You will work with providers, patients, and insurers to ensure timely access to services and continuity of care.

Responsibilities include processing referrals, obtaining prior authorizations, and maintaining EMR records, while upholding HIPAA standards and providing compassionate support to patients and families.